Published December 12, 2016
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Data from: A transmission-virulence evolutionary trade-off explains attenuation of HIV-1 in Uganda
Authors/Creators
- 1. Imperial College London
- 2. Johns Hopkins University
- 3. University of Washington
- 4. Makerere University
- 5. Walter Reed Army Institute of Research
- 6. Rakai Health Sciences Program
- 7. National Institutes of Health
- 8. University of Oxford
Description
Evolutionary theory hypothesizes that intermediate virulence maximizes pathogen fitness as a result of a trade-off between virulence and transmission, but empirical evidence remains scarce. We bridge this gap using data from a large and long-standing HIV-1 prospective cohort, in Uganda. We use an epidemiological-evolutionary model parameterised with this data to derive evolutionary predictions based on analysis and detailed individual-based simulations. We robustly predict stabilising selection towards a low level of virulence, and rapid attenuation of the virus. Accordingly, set-point viral load, the most common measure of virulence, has declined in the last 20 years. Our model also predicts that subtype A is slowly outcompeting subtype D, with both subtypes becoming less virulent, as observed in the data. Reduction of set-point viral loads should have resulted in a 20% reduction in incidence, and a three years extension of untreated asymptomatic infection, increas
ing opportunities for timely treatment of infected individuals.
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Related works
- Is cited by
- 10.7554/elife.20492 (DOI)